Poplar Pediatric Dentistry LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

POPLAR PEDIATRIC DENTISTRY LLC

Practice address

1667 N Lebanon St
Lebanon, IN 46052-1515

Phone

(317) 939-6558

NPI assigned

Sep 6, 2023

Organization subpart

Yes

Parent organization

POPLAR PEDIATRIC DENTISTRY LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Katelyn Brauer, DDSNPI 1407340276

Title

Owner

Phone

(317) 939-6558

Specialties & licenses 1

Addresses

Tax ID family

Poplar Pediatric Dentistry LLC2 organizations share this tax ID, including this one

Part of

Poplar Pediatric Dentistry LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Poplar Pediatric Dentistry LLC

  • Pediatric Dentistry
  • Zionsville, IN
  • NPI 1477186732
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Poplar Pediatric Dentistry LLC

  • Pediatric Dentistry
  • Zionsville, IN
  • NPI 1477186732
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katelyn Marie Brauer, DDS

  • Pediatric Dentistry
  • Indianapolis, IN
  • NPI 1407340276
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704067200000",
    "number": "1124804042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6828 W STONEGATE DR",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460778023",
            "telephone_number": "317-939-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1667 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521515",
            "telephone_number": "317-939-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPLAR PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POPLAR PEDIATRIC DENTISTRY LLC",
        "enumeration_date": "2023-09-06",
        "last_updated": "2024-01-01",
        "certification_date": "2024-01-01",
        "status": "A",
        "authorized_official_last_name": "BRAUER",
        "authorized_official_first_name": "KATELYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-939-6558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dustie Rose Pier, MA, BCBA
• Melanie Anne Piercy, PHARMD
• Mary Dee Ping, PT
• David William Pison, DO
• Joseph Plewa, LCSW
• Adriana Portes, RBT
• Jan S Potter
• Brett A Presley, M.D.
• Lacey Nicole Pulley, PA-C
• Jessica Marie Purvis, MSW, LCSW

• Pediatric Dentistry in Lebanon, IN
• Providers in Lebanon, IN by specialty
• Pediatric Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.